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After School Registration Form

- Current Parents

The maximum number of form submissions has been reached. This form is currently not available.
- STUDENT ATTENDING AFTER SCHOOL PROGRAM (ASP)
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Grade REQUIRED Please fill out this field.
- Student's Gender REQUIRED Male Female Please fill out this field.
- Medical Conditions REQUIRED Please fill out this field.
- MOTHER'S INFORMATION
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Work Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Email REQUIRED Please fill out this field. Please enter an email address.
- FATHER'S INFORMATION
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Work Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Email REQUIRED Please fill out this field. Please enter an email address.
- If school cannot contact parent or legal guardian, list friends or relatives of legal age who may be called upon if your child is sick. Also include the name(s) of any person who has your permission to sign for the early release of your child.
- EMERGENCY CONTACT'S INFORMATION
- Contact #1
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Contact #1 Relationship REQUIRED Please fill out this field. Please enter valid data.
- Contact #1 Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Contact #2
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Contact #2 Relationship REQUIRED Please fill out this field. Please enter valid data.
- Contact #2 Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
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